A defence psychiatrist concluded five days in the witness stand with the ringing declaration that “only a psychosis” can explain what Luka Magnotta did to Jun Lin, even as it became clearer than ever that this must have been the ne plus ultra of psychoses.

It was her final declaration in re-examination by Mr. Magnotta’s lawyer, Luc Leclair, but hardly her only staunch pronouncement on the central issue at trial, Mr. Magnotta’s state of mind in and around the May 25, 2012, killing of Mr. Lin.

Mr. Magnotta has acknowledged the “physical part” of the charges he faces, but is pleading not guilty via mental disorder.

Yet through prosecutor Louis Bouthillier’s cross-examination of Dr. Allard, the jurors were reminded of the reams of evidence before them, much of it video, in which Mr. Magnotta appeared not in the least out of touch with reality and was neither hiding from nor looking for the “government agents” he told Dr. Allard he believed were after him.

In one little gem, Mr. Boutillier produced a receipt which shows that on the day after Mr. Lin’s killing, as Mr. Magnotta was at a post office shipping off Mr. Lin’s body parts, he was still cool-headed enough to kill the proverbial two birds with one stone — he also bought a money order for $210 made out to a U.S. company.

In all the surveillance video of Mr. Magnotta – from cameras at his apartment building which caught him disposing of Mr. Lin’s legs and arms in the garbage, sometimes wearing the dead man’s clothes, and other footage which shows him at the post office, airports, hotels and bus stations in Europe — he seemed perfectly self-possessed.

To all of this, Dr. Allard gave fundamentally the same explanation throughout her week on the stand: One can be both chronically psychotic and functioning; Mr. Magnotta may have looked calm but who knows what was going on in his head or, as she put it Thursday, “A murder may be premeditated, planned and deliberate, within a psychosis.”

In other words, if it looks like a duck, and walks like a duck, and talks like a duck, it may well be a duck, not a psychotic.

Dr. Allard maintained that Mr. Magnotta chronically hid the most florid of his schizophrenia symptoms, the voices he heard, because he didn’t want to be abandoned, as his schizophrenic father was, by his family.

Yet Mr. Bouthillier showed, by displaying Mr. Magnotta’s first successful application for the Ontario Disability Support Program, a form of welfare, that in fact Mr. Magnotta went to great lengths to detail his “mental spells,” “halisonations (sic)” and the “voices in my head telling me to hurt myself.”

Handout/Lin Family/CPVictim Jun Lin

Dr. Allard explained that when Mr. Magnotta killed kittens for three online videos (he blamed a purported cruel client of his escort business, one Manny Lopez, for making him do it), “his judgment was certainly off,” but allowed to the prosecutor that, “The answer is yes, Yes, he knew it was wrong.”

But then, her view is that though Mr. Magnotta generally knew right from wrong, and could appreciate what he was doing, his psychosis didn’t allow him to “apply” that knowledge. As she told Mr. Bouthillier at one point, “He knew generally that killing was wrong and walking around with a severed head was wrong, but he was under a psychosis.”

Mr. Bouthillier pointed out in Dr. Allard’s lengthy report that Mr. Magnotta was fascinated by Basic Instinct, the 1992 movie starring Sharon Stone as a homicidal author Catherine Tramell, who was the chief suspect in the slaying of a lover.

He noted that Mr. Magnotta used “Catherine Tramell” as the user name on the laptop he had in Berlin; that the Stone character straddles her lover during sex and stabs him with an icepick, and that her dead fiancé, who is never seen on screen, was named Manny Vasquez.

Dr. Allard allowed that she may have wondered “if Mr. Lopez was part of his [Mr. Magnotta’s] delusion,” but in the end, she concluded he was a real person, albeit one the jurors haven’t seen.

The prosecutor asked about the extraordinarily lewd and vicious email he sent to a British newspaper in which he pledged he’d soon be making another movie, where the victims would be human, not cats, and which he signed as John Kilbride, the child victim of notorious British serial killers.

Why did he pick that name, Mr. Bouthillier asked. “He knew the story,” Dr. Allard said, “and decided to use the name. The name had popped up in his mind.”

So then, Mr. Magnotta used the name of a victim of serial killers, loved a dark movie where the crime strongly resembles the one he acknowledges committing, and killed kittens allegedly under duress by a man no one has seen here.

Are some men aroused by such cruelty, Mr. Bouthillier asked Dr. Allard once. They are, she said; in fact Mr. Magnotta, with the wisdom born of his time as an escort, told her that, she said, and she researched it. “He didn’t tell me he was aroused,” she added. “But can men be aroused producing such videos?” Mr. Bouthillier asked.

“Yes, and the answer is no, he [Mr. Magnotta] is not aroused by any violence.”

Two years ago, while in the care of a Kingston, Ont., mental hospital, a schizophrenic man named Jonah Fluxgold, 37, obtained a passport and $10,000 cash, illegally fled to Montreal, caught a plane to New York, where he lost the passport, and then to Sunnyvale, Calif., where he was arrested after a physical altercation with a family friend.

What should have been a brief elopement, however, grew into a legal fiasco, as Mr. Fluxgold was held in the Santa Clara county jail, variously refusing medication or having it forced on him, for almost two years, despite a warrant for his arrest that no one in Canada would enforce or pursue.

The saga took an unexpected twist Friday when Mr. Fluxgold was freed after pleading guilty to forcible confinement, having already served more than a full sentence awaiting trial. He was packed onto a bus bound for Seattle, where his mother expected him Sunday night.

Even the judge said this is a very sad story

As the Canadian government seeks to bring greater rigour to Canada’s handling of mentally ill offenders, Mr. Fluxgold’s continued absence from court-ordered care makes for a revealing case study in broad institutional failure, of a sort unaddressed by the latest victim-focused reforms.

Mr. Fluxgold has no money, no right to stay in the U.S., and an outstanding warrant that says he should be held securely in Ontario, following a 2008 judgment that he was not criminally responsible for a minor sexual assault in Toronto. Instead, on Sunday, he was on a California passenger coach, lurching, as his father believes, toward the next of his many ill-fated conflicts with police.

Courtesy of Howard FluxgoldTwo years ago, while in the care of a Kingston, Ont., mental hospital, a schizophrenic man named Jonah Fluxgold, 37, obtained a passport and $10,000 cash, illegally fled to Montreal, caught a plane to New York, where he lost the passport, and then to Sunnyvale, Calif., where he was arrested after a physical altercation with a family friend.

“He’s in limbo, basically,” said his father, Howard Fluxgold of Vancouver. “At the very least, he overstayed his welcome [in the U.S.].”

“The major failure is with how NCR [the not criminally responsible verdict] works,” Mr. Fluxgold said. “Nobody in this country had done anything to get my son back, even though almost from day one they knew where he was… Nobody’s done anything when they’ve had the opportunity.”

“It is extremely extraordinary,” said his mother Maryte Racys, who expected Jonah at her Seattle home Sunday night. “Even the judge said this is a very sad story. He was detained much too long.”

Jonah Fluxgold did not respond to a request for comment.

The symptoms of schizophrenia have dominated his adult life. Run-ins with police and drug use led to suicide attempts and elopements from group homes and hospitals in his native British Columbia. He obtained an undergraduate degree at UBC, but dropped out of a masters program at Concordia in Montreal because of his illness, which typically appears in early adulthood. A professor said his personality “disintegrated.”

Like his arrest at the 2007 Juno Awards in Saskatoon, when he managed to sneak into a limo and get backstage, the circumstances of the sexual assault suggest it is more a symptom than a crime. As a judge said, it “involved a transitory touching over the complainant’s clothing… Mr. Fluxgold testified, quite credibly even if unreasonably, that he believed [the complainant] had invited his advances.”

You’re messing with the wrong person

It was just after 9 a.m. in March, 2008, when he said hello in Chinese to a young female lawyer of Chinese background as she crossed a downtown street in Toronto. She ignored him, even as he followed her into her office elevator. When the doors closed, he tried to kiss her and grabbed her groin for two to three seconds, with “an expression on his face that suggested he was trying to seduce me.”

It failed. She dragged him by the collar out of the elevator saying “You’re messing with the wrong person.” Her citizen’s arrest was helped by two secretaries who locked Mr. Fluxgold in a room. He did not resist, and “seemed to be enjoying the experience,” a judge wrote, until a security guard arrived and decided there were no grounds to hold him.

A few days later, he returned to the office, asked for the woman, and was arrested as he sat in the waiting area. Out of what a judge called “an unusual, if belated, chivalrous concern for her sensibilities,” he was trying to offer her his $240 paycheque, “although it would have left him flat broke and he was trying to save the $1,000 deposit he needed to run as an independent candidate to become Prime Minister.”

He was found not criminally responsible for sexual assault and harassment, and sent to the maximum security Oak Ridge facility in Penetanguishene, Ont., before being transferred to the medium security Providence Continuing Care Centre in Kingston, where he was allowed to live in a group home, free from constant supervision.

Soon after, he was gone. A missing person campaign, and the frantic pleadings of his father to police, government and medical authorities, were all in vain.

I’m running out of hope, but I still have it

With the help of a relative, Howard Fluxgold tracked Jonah to New York, where police found him, but could not hold him because there was no American warrant for him, merely a Canadian border alert, evidently issued too late.

In California, he was picked up by police after a disturbance and taken to a mental hospital, which released him pending an immigration check. The family friends he was staying with were about to return him there when the forcible confinement took place.

He was acting disorganized and “crazy,” according to an arrest report, and tried to prevent the woman from leaving her house by locking the door and holding her as she tried to escape. The episode lasted about ten seconds. She screamed and got away as her husband tried to detain Mr. Fluxgold, but he escaped and was soon arrested.

“Your son pled guilty this morning,” reads an email to Howard Fluxgold from the Santa Clara district attorney’s office, sent Friday, nearly two years after he eloped from Kingston. “There was no useful purpose to keeping him on probation in Santa Clara County and he spent, including credits, the maximum time he could spend in jail.”

“My goal is to get him back to hospital, so hopefully he can still have a life, although I’m running out of steam,” said Mr. Fluxgold. “I’m running out of hope, but I still have it.”

Rick Warren’s 2002 self-help manual The Purpose Driven Life is one of the most popular books in the history of publishing. Its basic message — that we humans are not mere biological fragments, but exist as creatures of God’s mysterious will — has brought spiritual succor to tens of millions of Christians. These include kidnapper Brian Nichols, who famously released hostage Ashley Smith from an Atlanta apartment in 2005 after she read her kidnapper chapter 32 of Warren’s book.

Yet in the end, Warren, who has helped so many complete strangers find the strength to survive this vale of tears, could not make life bearable for his youngest son, Matthew. He committed suicide last week, after what is being described as a long battle with depression. “Despite the best health care available, this was a [mental] illness that was never fully controlled, and the emotional pain resulted in his decision to take his life,” Rick Warren’s church declared in a statement on Saturday.

The family’s tragedy is a particularly horrible manifestation of a lesson that has emerged from psychiatry and related disciplines over the last century: Our ability to experience pleasure, happiness and meaning in life mostly is governed by our brain chemistry. Self-help books, supportive family, intelligent life decisions, good luck and other environmental factors can help us make the most of the genetic hand we’re dealt. But ultimately, people with psychiatric ailments typically cannot be treated effectively except by altering their brain chemistry — a scientific project that is still in its infancy, and which fails many mentally ill people, including, apparently, Matthew Warren.

Even among the mentally healthy, genetic factors play a large role in defining our ability to enjoy life. In a famous 1996 article, behavioral geneticist David Lykken illustrated his so-called “set-point” theory of happiness with the observation that “one can predict a person’s SWB [subjective well-being] far more accurately from his identical co-twin’s score even 10 years earlier than from that person’s income, professional status, or social position today.”

Biological determinism also has overturned our understanding of human evil. Luka Magnotta is seen by many Canadians as a monster. But the recently disclosed fact that he was diagnosed early in life with paranoid schizophrenia means he is also a man with a serious and incurable disease. The same is true of 2009 Greyhound-bus murderer Vince Li, Arizona mass murderer Jared Lee Loughner, Colorado killer James Holmes, Virginia Tech shooter Seung-Hui Cho and probably Sandy Hook gunman Adam Lanza.

Every one of these shootings set off a debate about gun control. The real issue, however, is psychosis control: In most of these cases, the killer or a close family member reached out for mental-health treatment before the killings happened. But there is no pill that can cure schizophrenia or bipolarity. There are only treatments that temporarily suppress the symptoms, and not all patients respond to them.

Insofar as human misery is concerned, faulty brain chemistry produces its grimmest harvest not in a hail of bullets, but tucked away in the top floors of nursing homes — where victims of advanced-stage Alzheimer’s live out their foggy twilight, unable to remember or even recognize the people they once loved.

This mental degradation strips society of the benefit of many wise, older minds. Margaret Thatcher, for instance, was afflicted with Alzheimer’s for at least the last five years of her life. Imagine how much richer the world of ideas would have been if she’d been of sound mind until her very last days. The same is true of Ronald Reagan.

Just a generation ago, old people primarily were concerned with cancer, heart disease and stroke. But when my parents and their friends, who are in their 70s, speak to me about their greatest health fears, they are more likely to talk about their brains than everything that falls below the jawline put together.

An analogous process has changed the nature of parental anxieties. We now worry as much about autism as leukemia: The fight against childhood cancer has generated some huge victories in recent decades; the struggle against autism, none.

A cure for Alzheimer’s or Parkinson’s or autism would be the modern scientific equivalent of the smallpox and polio vaccines rolled into one. This is why I applaud Barack Obama, who last week detailed a new public-private initiative known as Brain Research through Advancing Innovative Neurotechnologies (BRAIN), modeled after the hugely successful Human Genome Project. The project will not target any one disease or condition, but instead is aimed at producing the world’s first rudimentary map of the human brain’s 85-billon neurons (though many researchers are more likely to start with the fruit fly, which has a mere 100,000). According to the National Institutes of Health, the holy grail is something that “shows how individual cells and complex neural circuits interact in both time and space.”

Mr. Obama is earmarking $100-million for this project. But an investment orders of magnitude higher might easily be justified. Whether it is overcoming depression, paranoid schizophrenia, autism, Alzheimer’s or any of the many other conditions that afflict our species, the battle against faulty brain chemistry is becoming the great medical struggle of our time. No other challenge or threat — not fiscal collapse, not global warming, not terrorism — takes a greater toll in ruined lives.

A new study is pointing to a surprising trend concerning one of the most devastating and misunderstood of mental illnesses, suggesting Canada is a growing hotbed for schizophrenia.

Rates of the mental illness are climbing in this country and are already significantly higher than the average for the rest of the world, concludes the research.

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Possible explanations for the apparent phenomenon are equally unusual.

One theory is that the condition is linked to vitamin-D deficiency, common in sun-deprived northern latitudes. A large population of immigrants — whose stressful, newcomer status has also been associated with increased risks for schizophrenia — are another potential cause, said Marie-José Dealberto, a Queen’s University psychiatrist and the author of the new study.

She noted the disorder usually strikes when people are teenagers or young adults and the impact on them “is enormous.”

“These results give much concern due to the serious personal, social and financial burden of schizophrenia,” warns her study in the journal Psychiatry Research, touted as the first analysis of its kind.

Other researchers, though, say the findings are intriguing but not entirely convincing, arguing the data behind the study are far from definitive.

Schizophrenia is a biochemical disorder that interferes with the sufferer’s connection to reality, causing delusions, hallucinations and social withdrawal.

There are, in fact, no conclusive national statistics on the prevalence of schizophrenia in Canada.

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Dr. Dealberto’s study analyzed a series of smaller studies, most looking at individual provinces, to come up with average rates of the disease.

Then she compared them to international data, subtracting the Canadian statistics from those world studies.

She concluded that 3.86 of every 1,000 Canadians — about 115,000 people — suffer from schizophrenia, well above the outside-Canada rate of 2.55.

Every year, Canada sees about 25.9 new schizophrenia cases per 100,000 people, more than double the 11.8 out of 100,000 rate in the rest of the world, the paper suggests.

Her analysis of 12 studies over the last 30 years or so also indicated a gradual increase in rates.

The small number of Canadian studies considered in the review and the quality of the data in that research, however, call into question the conclusions, said Dr. Taryn Tang, research head at the Schizophrenia Society of Ontario.

“It’s an interesting study. It’s an area that brings up a lot of questions,” she said. “[But] I think we need to be cautious.”

Dr. Kwame McKenzie, a schizophrenia expert at Toronto’s Centre for Addiction and Mental Health, raised similar questions, saying he was not “100% convinced” by the research.

‘I fully believed I was a prophet, I fully believed I was communicating with God. At one point, I actually believed I was Jesus Christ’

The suggestion that there is more schizophrenia the further north one goes in the world, and that lack of vitamin D is to blame, is an interesting idea, but has little solid proof behind it yet, he said.

However, there is strong evidence suggesting that someone who emigrates to another country is at much greater risk of succumbing to schizophrenia — likely because of the interplay between outside forces and brain chemistry that are now believed to be key in the illness, said Dr. McKenzie.

Research also indicates that people subject to racism and other forms of discrimination, and those undergoing major life changes and otherwise facing stress are more susceptible to schizophrenia — and those are all factors experienced by new immigrants, he noted.

Dr. Tang said those problems may be more acute for immigrants now than several decades ago, since there are fewer jobs generally and larger numbers of highly skilled newcomers who cannot find work in their field.

Meanwhile, Jesse Bigelow would like Canadians to better understand the debilitating disease and realize that many patients, like him, can lead productive lives under treatment.

As a teenager, he led an enviable existence: skilled at sports, he also played in rock bands and had no shortage of girlfriends.

Then at 19, Mr. Bigelow began hearing male voices he thought were the devil, perceived female voices that seemed divine, and was often overcome with paranoia.

“I fully believed I was a prophet, I fully believed I was communicating with God,” he said Tuesday. “At one point, I actually believed I was Jesus Christ.”

Mr. Bigelow, now 34, was eventually diagnosed with schizophrenia. Now taking the anti-psychotic drug clozapine, he is symptom-free and works as a mental-health peer supporter for other patients.

One doesn’t really expect to see horseback riding and psychiatric illness mentioned in the same sentence, let alone combined as a form of health care. But a recent Canadian study suggests that riding may actually be beneficial for people with schizophrenia. And that is only the tip of the iceberg, it seems, when it comes to horses and treatment.

A paper published in the Community Mental Health Journal by researchers from the University of Western Ontario psychiatry department recounts how six patients with schizophrenia or the related schizoaffective disorder had weekly riding sessions for 10 weeks with experienced “therapeutic horseback riding” instructors.

Related

Interviews with the patients, and the mental-health staff who accompanied them, suggested the horse treatment helped the patients feel better, though the sample was small and the measurement of success largely subjective.

Still, using horseback riding as a therapy for people dealing with problems ranging from disability to autism and emotional or psychological distress seems to be spreading.

For instance, experiencing the rhythmic motion of a horse can be very beneficial. Riding a horse moves the rider’s body in a manner similar to a human gait, so riders with physical needs often show improvement in flexibility, balance and muscle strength.

A Jamaican native who blamed a series of violent assaults on his paranoid schizophrenia has lost a bid to stay in Canada on compassionate grounds.

Federal Court Justice David Near ruled that mental illness does not give permanent residents any greater right to stay in Canada.

Audley Horace Gardner came to Canada as a teenager 30 years ago at the invitation of his sister. Eight years later, he was diagnosed with schizophrenia and in the early 1990s was found not criminally responsible for a violent offence.

For a decade, he was treated as an out-patient with anti-psychotic drugs, switching from injections administered by nurses to pills in 2003. Then things took a turn for the worse.

He was evicted from his apartment and his schizophrenic symptoms resurfaced, as he was apparently unable to stay on the drugs. Mr. Gardner moved from homeless shelter to homeless shelter and was eventually convicted in 2005 of stabbing a fellow shelter resident and of two other assaults. He was ordered deported in 2007, with the Immigration Appeal Division later ruling he posed too great a danger to the Canadian public.

The 48-year-old appealed on humanitarian grounds but the government deemed the risk he presented to the public outweighed the dangers he would face returning to Jamaica, where one expert suggested he would receive inadequate care. Mr. Gardner appealed to the Federal Court, but Judge Near ruled recently the decision had been reasonable.

The case underlines the perils of immigrants not becoming citizens, and the balance that has to be found in such cases between the public interest and individual rights, said Sergio Karas, a Toronto immigration lawyer.

”This person is obviously mentally ill and needs treatment, but on the other hand, he is a violent offender,” he said.

Permanent residency status is not permanent for all immigrants; those convicted of serious crimes can be kicked out of the country, even if they arrived many years earlier. But what if the immigrant’s crimes were the result, not of conscious, sane intent, but of psychiatric illness?

Such appears to be the case with Audley Horace Gardner, a Jamaican native with paranoid schizophrenia whose deportation order was confirmed by a Federal Court judge recently. Illness, it turns out, does not exempt non-citizens from the deportation rule.

Mr. Gardner came to Canada 30 years ago at the invitation of his sister. Eight years later, he was diagnosed with schizophrenia and in the early 1990s was found not criminally responsible for a violent offence. For a decade, he was treated as an out-patient with anti-psychotic drugs, switching from injections administered by nurses to pills in 2003. Then things took a turn for the worse.

He was evicted from his apartment and his schizophrenic symptoms resurfaced, as he was apparently unable to stay on the drugs. Mr. Gardner moved from homeless shelter to homeless shelter and was eventually convicted in 2005 of stabbing a fellow shelter resident and of two other assaults. He was ordered deported in 2007, with the Immigration Appeal Division later ruling that he posed too great a danger to the Canadian public.

The 48-year-old appealed on humanitarian and compassionate grounds but the government deemed that the risk he presented to the public outweighed the dangers he would face returning to Jamaica, where one expert suggested he would receive inadequate care. Mr. Gardner appealed to the Federal Court. But Justice David Near ruled the decision had been reasonable, and that mental illness does not give permanent residents any greater right to stay in Canada.

The case underlines the perils of immigrants not becoming citizens, and the balance that has to be found in such cases between the public interest and individual rights, said Sergio Karas, a Toronto immigration lawyer. Said Mr. Karas:

This person is obviously mentally ill and needs treatment, but on the other hand, he is a violent offender.

The debate continues over legalization or de-criminalization of marijuana. Why, some ask, is possession of the drug a criminal offence, when legal substances like alcohol and tobacco cause far more health and social calamity? Its criminalization, the argument goes, only perpetuates organized crime groups that thrive on illegal, and sought-after, commodities. A new Canadian research paper, though, reminds us that marijuana is not without its dangers, especially for teenagers.

The article by researchers at the Youthdale Child and Adolescent Sleep Centre and University of Toronto psychiatry department reviewed studies on the possible link between cannabis and the onset of psychosis. Psychosis is the loss of contact with reality, with symptoms like hallucinations and delusions, often caused by schizophrenia.

The evidence suggests that cannabis use is a significant risk factor for psychosis, concludes the paper in the Journal of Psychosomatic Research, noting that the cognitive effects of marijuana are more pronounced in adolescents because their brains are still developing.

Some studies have pointed to cannabis being an environmental trigger for diseases like schizophrenia among a sub-set of people who already have a genetic predisposition to the illness.

Says the article:

Cannabis is a widely used substance that may be becoming more socially acceptable, legally tolerated and utilized by younger individuals.

The risk that cannabis poses to adolescent health should not be neglected. Policy measures should use a multifaceted and strategic perspective in order to prevent adolescents from using the drug.

]]>http://news.nationalpost.com/health/dont-forget-pot-psychosis-link-review-warns/feed2stdThe article by researchers at the Youthdale Child and Adolescent Sleep Centre and University of Toronto psychiatry department reviewed studies on the possible link between cannabis and the onset of psychosis.